Provider Demographics
NPI:1851656466
Name:RODRIGUEZ, MELANIE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1748
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-1748
Mailing Address - Country:US
Mailing Address - Phone:787-613-8032
Mailing Address - Fax:787-803-2106
Practice Address - Street 1:CALLE JOSE I QUINTON 33
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00769
Practice Address - Country:UM
Practice Address - Phone:787-803-2115
Practice Address - Fax:787-803-2106
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17871104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker